pregabalin (Lyrica OD)

Gabapentin-Induced Severe Vivid Nightmares: A Case Series and Brief Review.

Hasoon Jamal J, Nguyen Anvinh A, Safabakhsh Negaar Ada NA, Viswanath Omar O et al.

Gabapentin is widely prescribed for neuropathic and radicular pain syndromes. While somnolence and dizziness are well-recognized adverse effects, severe vivid nightmares may constitute an underreported psychiatric side effect that can significantly impair quality of life and treatment adherence. We present two cases of gabapentin-induced severe vivid nightmares in patients treated for spinal pain syndromes. Management strategies included medication discontinuation and transition to pregabalin. Both patients experienced resolution of nightmares following intervention. This report reviews the existing literature on gabapentin's effects on sleep architecture and discusses potential mechanisms, clinical implications, and management approaches.

Therapeutic drug monitoring uncovering incorrect antiretroviral drug intake in a patient with swallowing difficulties.

Carrozzo Giorgia G, Cattaneo Dario D, Giacomelli Andrea A, Gori Andrea A et al.

A woman living with HIV reported swallowing difficulties that interfered with oral antiretroviral therapy. Treatment with darunavir/cobicistat/emtricitabine/tenofovir alafenamide (Symtuza®) was initiated, with the patient choosing to chew the tablet before swallowing because of her swallowing difficulties. Therapeutic drug monitoring, performed because of this non-standard administration, revealed unexpectedly low darunavir trough concentrations despite reported adherence and maintained virological suppression. A structured pharmacological assessment revealed that the patient had been consistently taking the medication in the fasting state, despite initial counselling to take it with food. After correction of the drug intake conditions, darunavir exposure increased to therapeutic levels. This case highlights the clinical value of therapeutic drug monitoring in identifying medication intake errors and optimising antiretroviral therapy in patients with swallowing difficulties.

Evaluation of the Protective Effect of a Well-Characterized n-Hexane Extract of Black Soldier Fly Larvae (Hermetia illucens) Against Acrylamide-Induced Testicular Damage in Male Rats: A Histopathological, Oxidative Stress, Inflammatory, and Molecular Study.

Heidari Fateme F, Zarei Taher Tahereh T, Arast Yalda Y

Acrylamide (ACR) is a ubiquitous contaminant present in environmental and dietary sources and is formed particularly in starchy foods during high-temperature processing. Prolonged exposure to ACR is associated with testicular dysfunction mediated by oxidative injury, inflammatory responses, and apoptotic cell death. Black soldier fly larvae (BSFL; Hermetia illucens) represent a sustainable source of bioactive lipids, notably lauric acid, which has recognized antioxidant and anti-inflammatory properties. Importantly, BSFL can be cultivated on organic waste, converting low-value materials into lipid-enriched biomass with therapeutic potential, consistent with the principles of the circular economy. This study was designed, for the first time, to investigate the protective potential of a chemically characterized n-hexane extract of BSFL against acrylamide-induced testicular toxicity in a rat model. Thirty-five adult male Wistar rats were allocated to five experimental groups (n = 7 per group): vehicle control, ACR (20 mg/kg), ACR plus BSFL180 (180 mg/kg), ACR plus BSFL360 (360 mg/kg), and BSFL360 alone. All treatments were administered orally for 28 consecutive days. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and dihydrotestosterone (DHT) were measured. Testicular specimens were analyzed for oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GPx], reduced glutathione [GSH]), inflammatory cytokines (TNF-α, IL-6, IL-1β), and apoptosis-related proteins (Nrf2, Bcl-2, Bax). Histological assessment was performed using H&E staining. ACR administration markedly reduced serum FSH, LH, and DHT levels; increased MDA and pro-inflammatory cytokine levels; suppressed antioxidant enzyme activities and GSH content; and induced severe histopathological damage. Co-administration of BSFL extract, particularly at 360 mg/kg, dose-dependently counteracted these detrimental effects. Western blot analysis showed that BSFL extract upregulated Nrf2 and Bcl-2 expression while downregulating Bax, thereby restoring the Bax/Bcl-2 balance. The extract alone produced no adverse effects. The n-hexane extract of BSFL exerts substantial protective effects against ACR-induced testicular toxicity by restoring hormonal balance, mitigating oxidative stress, suppressing inflammation, and modulating Nrf2 and Bax/Bcl-2 signaling. These findings highlight the therapeutic potential of BSFL as a sustainable, cost-effective natural product within a circular bioeconomy framework and a novel approach to preventing chemically induced testicular injury.

Letter to the Editors on "Analysis of the effects of combined electrical spinal cord stimulation and pregabalin therapy in patients with herpes zoster trigeminal neuralgia" by Jiang et al.

Vannemreddy Prasad S PS, Bahrii Romana V RV, Slavin Konstantin V KV